At its December 1, 2021 meeting, the Board defined advanced training.
The Board has recently been asked to respond to several inquiries regarding student performance of physical therapy interventions learned in entry level and whether they may be performed in clinicals prior to graduation, specifically, dry needling and internal pelvic examinations. The Board has previously determined dry needling and internal pelvic examinations to be “advanced” skills that require advanced training.
North Carolina PT and PTA students are educated in CAPTE accredited educational programs. CAPTE reviews and updates its entry level criteria approximately every 5 years. A search of the most recent CAPTE requirements does not include dry needling and internal pelvic examinations as entry-level requirements. The Board reviews and makes determinations on scope of practice questions for licensees based on several criteria including what is taught in entry level PT academic education and what meets the criteria outlined in Board rule 21 NCAC 48C .0101 Permitted Practice. 21 NCAC 48C .0101 PERMITTED PRACTICE states: (a) Physical therapy is presumed to include any acts, tests, procedures, modalities, treatments, or interventions that are routinely taught in educational programs or in continuing education programs for physical therapists and are routinely performed in practice settings.
Using the Board rule noted and the Merriam-Webster definition of the word “advanced”:
Students who are in the process of didactic and clinical training do not meet the definition of “advanced”. While some NC PT/PTA programs may choose to offer additional training not required as part of a required CAPTE entry level curriculum, the Board must consider as a whole the training offered throughout the state. The Board is tasked with considering what that training entails in order to protect the safety and welfare of the citizens of North Carolina and establish minimum standards for the practice of physical therapy.
To achieve advanced level skill, additional training is necessary to become competent. In addition to participating in additional training, students must become licensed. It is useful for licensees to participate in additional training via mentored practice for specific higher risk techniques prior to performing these in clinical practice. Therefore, for the reasons stated above, when the Board uses the term “advanced” it means “beyond entry-level” for the skill level or training required. This term is currently used in, but not limited to position statements and responses to scope of practice questions.